Polypoidal choroidal vasculopathy in Caucasians

Purpose: To study the prevalence of polypoidal choroidal vasculopathy (PCV) in Caucasian patients with occult choroidal neovascularization (CNV); to s tudy the clinical spectrum of PCV in Caucasians and the outcome after laser photocoagulation of such lesions. Methods: (1)A consecutive series of 374 eyes of Caucasian patients at least 58 years old, presenting occult CNV, pr esumed to have age-related macular degeneration (BMD) on fluorescein angiog raphy (FA) were further characterized by indocyanine green angiography (ICG A) to determine the frequency of PCV. (2) The funduscopic, FA and ICGA find ings in a cohort of 36 Caucasian patients with PCV were analyzed. (3) The o utcome after laser photocoagulation was studied in 14 PCV eyes with a minim um follow-up of 6 months. Results: (1) Fourteen of 374 eyes (4%) presenting occult CNV in patients at least 58 years old were diagnosed as PCV by mean s of ICG-A. (2) A polypoidal lesion was found in the macula in 22 of 45 PCV eyes, in the peripapillary area in 16 of 45, under the temporal Vascular a rcade in 6 of 45 and in the midperiphery in 6 of 45. Large or soft drusen w ere observed in 15 of 45 eyes with PCV, (3) Regression of fundus signs with out persisting polyps 6 months after laser photocoagulation was obtained in 5 of 5 treated peripapillary lesions but in only 5 of 9 treated macular or arcade lesions. Conclusion: Polypoidal choroidal vasculopathy is not rare in Caucasian patients presenting with occult choroidal neovascularization, The fundus abnormalities seen in such eyes overlap with the typical manifes tations of AMD. Whereas the prognosis after photocoagulation of peripapilla ry polypoidal lesions appears to be relatively good, it is more guarded for macular or arcade lesions.